Anesthesiology NewsUpdated Guidelines Provide New Tactics for SSI Prevention

Multidisciplinary Expert Panel Revises Recommendations to Target Zero Harm in Surgical Procedures

In a collaborative effort to minimize the risk of surgical site infections (SSIs), a panel of experts from leading healthcare organizations has released updated guidelines. These new recommendations aim to provide healthcare professionals with evidence-based practices to prevent SSIs, which remain a significant concern for patient safety and healthcare costs.

HCN Medical Memo
These updated guidelines offer a structured approach to preventing SSIs, a common yet preventable healthcare-associated infection. The emphasis on evidence-based practices and the categorization of recommendations provide a roadmap for acute care settings. Adherence to these guidelines not only enhances patient safety but also contributes to the broader goal of reducing healthcare-associated infections and associated costs.

Key Points

• The Society for Healthcare Epidemiology of America (SHEA) led the initiative, partnering with multiple organizations including the CDC.
• SSIs occur in 1% to 3% of patients undergoing inpatient surgery and can increase mortality rates by up to 11 times.
• The guidelines categorize recommendations into “essential practices,” “additional approaches,” “not recommended,” and “unresolved issues.”
• Essential practices include discontinuing antimicrobial prophylaxis at the time of incision closure and specific preoperative preparations for various types of surgeries.
• Philip S. Barie, MD, emphasized the need for local adaptation of these national guidelines for effective implementation.

“I agree personally with every single recommendation, positive or negative, but it’s important to remember that these are national guidelines. In order for them to be implemented, they have to be translated at some point into local guidelines. All institutions have to get buy-in from their practitioners, and then also agree in some manner to standardize and monitor.”
– Philip S. Barie, MD, Professor Emeritus of Surgery and of Public Health in Medicine, Weill Cornell Medicine, New York City, and the Executive Director of the Surgical Infection Society Foundation for Education and Research

Additional Points

• The routine use of vancomycin is not recommended and should be reserved for specific clinical situations.
• Negative-pressure dressings and antiseptic-impregnated sutures are now considered as additional approaches.
• The guidelines also discuss unresolved issues such as the use of supplemental oxygen for patients requiring ventilation.

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